高龄急性肾衰患者血液净化治疗效果分析  

The Effect of Blood Purification in Senile Acute Renal Failure (ARF) Patients

作　　者：张桂华[1] 刘兴佳[1] 王琳[1] 阎世平[1] 

机构地区：[1]大连大学附属医院肾内科,大连116021

出　　处：《临床急诊杂志》2004年第1期8-10,共3页Journal of Clinical Emergency

摘　　要：目的:分析高龄急性肾衰患者血液净化效果,探讨其治疗的特殊性。方法:回顾性分析在我院诊治并进行血液净化的急性肾衰高龄患者资料共22例,其中1个器官衰竭1例,2个器官衰竭11例,3个器官衰竭6例,4个器官衰竭2例,5个器官衰竭2例。进行血液透析(HD)治疗15例,连续性静脉-静脉血液滤过(CVVH)治疗7例。结果:22例高龄ARF患者均经积极治疗原发病、抗感染、输血、补液、控制血压等对症治疗,存活16例,死亡6例,进行HD治疗共215次,死亡4例,进行CVVH治疗共41次,死亡2例。死亡病例包括4和5个器官衰竭患者4例,3个器官衰竭者1例和2个器官衰竭者1例。结论:高龄ARF患者病情变化较快和复杂,早期积极治疗并根据病情需要选择不同的血液净化疗法可减少合并症。一旦发现高龄ARF患者,应立即采取血液净化治疗。连续性肾脏替代治疗(CRRT)由于血流动力学稳定,对高龄合并多器官功能衰竭者比一般血透治疗更具优越性。Objective: To analyze the effects of blood purification in senile acute renal tailure( VRF) patients and investigate the specification of this kind of treatment. Methods:Petrospective study of 22 cases of senile ARF patients underwent blood purification, one case with one organ failure, 11 cases with two organs failure,6 cases with three organs failure,2 cases with four organs failure and 2 cases with five organs failure. Among them 15 cases underwent hemodialysis( HD) ,and 7 cases underwent continuous venous - venous hemofiltrationt CVVH) . Results: All patients have received treatment of original disease, anti - inflammatory therapy, transfusion, intravenous infusion and blood pressure control,16 patients are survived and 6 patients died. 15 patients received 215 times HD, among them 4 patients died. 7 cases received 41 times CVVH. 2 patients died. Among the death, 4 cases with four or five organs failure, 2 cases with two or three organs failure. Conclusion:The clinical findings of ARF in the elder patients were complicated and rapidly developed, immediate and proper blood purification to difficult cases might reduce the complication. Once diagnois certained the elder patients with ARF should receive blood purification immediately. Because of the hemodynamical stability of continuous renal replace therapy (CRRT) to elder patients with multiorgan dysfunction syndrome,it is much better than hemofiltration.

关 键 词：血液净化 治疗 ARF 临床资料 急性肾功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学] R457[医药卫生—外科学]